Contents

Accelerated Aging

Evidence shows that alcohol consumption can cause both accelerated agingin which symptoms of aging appear earlier than normaland exaggerated aging, in which the symptoms appear at the appropriate time but in a more exaggerated form.

Brain Shrinkage

A study[2] by researchers at the Johns Hopkins Bloomberg School of Public Health and other institutions found a link between low to moderate alcohol consumption and a decrease in the brain size of middle-aged adults. Brain atrophy is associated with impaired cognition and motor functions.

People who drink the equivalent of three large glasses of wine a night can suffer brain damage similar to that seen in chronic alcoholics, research suggests. Scientists found that people who consumed more than 100 drinks a montharound 130 unitssuffered from loss of memory, reduced intelligence, poor balance and impaired mental agility. Brain malfunctions linked to alcohol included the inability to apply consequences from past actions, difficulties with abstract concepts of time and money and difficulties with storing and retrieving information.

The shrinkage observed seems to be more extensive in the cortex of the frontal lobe, which is believed to be the seat of higher intellectual functions. This shrinkage generally increases with age, at least in men.

Repeated imaging of a group of alcoholics who continued drinking over a 5-year period revealed progressive brain shrinkage that significantly exceeded normal age-related shrinkage. The rate of frontal cortex shrinkage correlates closely with the amount of alcohol consumed.

But this shrinkage has also been observed in deeper brain regions, including brain structures associated with memory, as well as in the cerebellum, which helps regulate coordination and balance.

Reversing the Effects

Researchers do not agree on the effect this brain shrinkage has on memory loss and problem-solving skills. Some studies show no effect, while others have reported some loss in those skills, associated with alcohol-induced brain shrinkage. However, these effects are usually reversed with alcohol abstinence. Even quitting drinking for 3-4 weeks has shown to reverse the effects on memory loss and problem-solving skills.

Brain shrinking is especially extensive in the cortex of the frontal lobethe location of higher cognitive faculties.

The best predictor of alcohol related impairment is: maximum quantity consumed at one time, along with the frequency of drinking that quantity.

In general, skills that require novel, complex, and rapid information processing take longest to recover. New verbal learning is among the first to recover. Visual-spatial abilities, abstraction, problem solving, and short-term memory, are the slowest to recover. There may be persistent impairment in these domains... Indications of structural pathology often disappear completely with long-term abstinence.

Reduced density of white matter was found in the periventricular area, pons and cerebellar pedunculi in alcohol patients. We conclude that our findings provide the evidence that alcohol addiction is associated with altered density of grey and white matter of specific brain regions. This supports the assumption that alcohol dependence is associated with both local grey matter dysfunction and with altered brain connectivity.

The results show that the degree of brain damage is related to the intensity of exposure to alcohol and clearly indicate that psychological testing is a reliable method for, at least, an initial diagnosis of or screening for alcohol-related cerebral atrophy.

Consumption of alcoholic beverages is known to be a human carcinogen
based on sufficient evidence of carcinogenicity in human studies that
indicate a causal relationship between consumption of alcoholic
beverages and cancer. Studies indicate that the risk of cancer is most
pronounced among smokers and at the highest levels of consumption.
Consumption of alcoholic beverages is causally related to cancers of the
mouth, pharynx, larynx, and esophagus. Cohort and case control
studies in a variety of human populations are notable for their
consistency in reporting the presence of moderate to strong associations
with dose-response relationships for these four sites. Evidence supports
a weaker, but possibly causal, relation between alcoholic beverage
consumption and increased risk of cancers of the liver and breast
(Longnecker 1994). The effect of a given level of alcoholic beverage
intake on absolute risks of cancer of the mouth, pharynx, larynx, and
esophagus is influenced by other factors, especially smoking. However,
smoking does not explain the observed increased risk of cancers
associated with increased alcoholic beverage consumption (IARC 1988,
Longnecker and Enger 1996).

Additional Information Relevant to Carcinogenicity

Increased frequencies of chromosomal aberrations, sister chromatid
exchanges, and aneuploidies have been found in the peripheral
lymphocytes of alcoholics. Ethanol-free extracts of some alcoholic
beverages induced sister chromatid exchanges in human cells in vitro
and mutations in bacteria (IARC 1988).

The mechanism by which consumption of alcoholic beverages can
cause cancers in humans is not established.

Women

We were able to confirm the telescoping course of alcohol dependence in women, meaning faster progression of the developmental events leading to dependence among female alcoholics and an earlier onset of adverse consequences.

We confirmed greater brain atrophy in alcoholic women and men compared to healthy controls. Furthermore, the women developed equal brain-volume reductions as the men after a significantly shorter period of alcohol dependence than the men. These results corroborate previous studies that have found other gender-related consequences of alcohol, such as cognitive deficits, alcoholic cardiomyopathy, myopathy of skeletal muscle, and alcoholic liver diseaseall of which occur earlier in women than in men despite a significantly shorter exposure to alcohol.

The good news is that abstinence seems to partially reverse the brain atrophy, for both genders.

The main finding was that the alcohol-dependent women showed less activation in brain areas that are needed for spatial tasks like puzzles, maps and mechanics, and for working with information that is held mentally, like doing math inside your head or making sense of a lecture or set of complex instructions. The brain parts that showed the differences are in areas that we need for finding our way around, and working with all the information we are bombarded with in everyday life.

A woman's risk of breast cancer increases by seven per cent for each alcoholic drink consumed on a daily basis. The seven per cent risk increase relates to a standard international unit of alcohol10 grams. In the UK, one standard unitwhich is equivalent to a small glass of wine or half a pint of beeris 8 grams.

Among women in the Nurses' Health Study, two or more drinks a day increased the chances of developing breast cancer by 20%-25%.[3]

Getting extra folic acid may cancel out this alcohol-related increase. In the Nurses' Health Study, for example, among women who consumed one alcoholic drink a day or more), those who had the highest levels of this B vitamin in their blood were 90% less likely to develop breast cancer than those who had the lowest levels of the B vitamin.ibid.

"Before about 60, breast cancer is a more important cause of death than heart disease," says Gillian Reeves of the Cancer Research UK Epidemiology Unit. "After the age of 65 or so, when the risk of heart disease becomes much greater than the risk of breast cancer, the benefits of moderate drinking are more apparent."

After six to nine months of abstinence from alcohol, recovering alcoholics who were also chronic smokers showed a significantly lower rate of improvement in tests of memory, reasoning, judgment, and visual/spatial coordination...

Recovery

Brain damage is a common and potentially severe consequence of long-term, heavy alcohol consumption. Even mild-to-moderate drinking can adversely affect cognitive functioning (i.e., mental activities that involve acquiring, storing, retrieving, and using information).

Most alcoholics exhibit mild-to-moderate deficiencies in intellectual functioning, along with diminished brain size and regional changes in brain-cell activity. The most prevalent alcohol-associated brain impairments affect visuospatial abilities and higher cognitive functioning...Higher cognitive functioning includes the abstract-thinking capabilities needed to organize a plan, set it in motion, and change it as needed.

Most alcoholics entering treatment perform as well as nonalcoholics on tests of overall intelligence. However, alcoholics perform poorly on neuropsychological tests that measure specific cognitive abilities. For example, an alcoholic who has remained abstinent after treatment may have no apparent difficulty filing office documents correctly, a task that engages multiple brain regions. However, that same person might be unable to devise a completely different filing system, a task closely associated with higher cognitive functioning.

Although the alcoholic subjects had abnormal patterns of brain activation, compared with control subjects, they were able to complete the tasks equally well, suggesting that the brain systems in alcoholics can be functionally reorganized so that tasks formerly performed by alcohol-damaged brain systems are shunted to alternative brain systems.

Functional brain reorganization may be particularly advantageous for adolescent alcohol abusers in treatment, because their developing brains are still in the process of establishing nerve-cell networks.

Regrowth of the frontal cortex in particular could be essential for a successful recovery. Including certain activities in therapyactivities that require the use of the frontal cortex, the site of executive function, impulse inhibition and goal settinghave been shown to improve recovery and increase retention in the treatment program. Also, thiamine therapy seems to increase treatment effects, likely by restoring aspects of central nervous system function.

A team of Canadian psychotherapists has reported evidence that the hallucinogenic drugssuch as LSD, mescaline, and psilocybincan be used with "cautious confidence" in treating alcoholics and other patients with psychiatric problems. The research used LSD-25, mescaline, or both, for psychedelic therapy. Seventy-nine percent of the patients were treated only once.

Benefits

"We should not encourage people to start drinking specifically to protect their heart, as there are much safer options. Our advice remains the samethe best way to reduce the risk of heart disease is to quit smoking if you smoke, increase levels of physical activity and eat a healthy balanced diet."[5]

"Research suggests that the type of drink may be important and adds to the evidence that red wine may have specific benefits over and above other alcoholic drinks."[6]

"None of the health benefits of alcohol come from binging. While a glass of red wine may reduce the risk of heart disease, binging increases it."[7]

It's safe to say that alcohol is both a tonic and a poison. The difference lies mostly in the dose. Moderate drinking seems to be good for the heart and circulatory system, and probably protects against type 2 diabetes and gallstones.

More than 100 prospective studies show an inverse association between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. The effect is fairly consistent, corresponding to a 25-40% reduction in risk.

If all drinkers limited themselves to a single drink a day, we probably wouldn't need as many cardiologists, liver specialists, mental health professionals, and substance abuse counselors. But not everyone who likes to drink alcohol stops at just one.

The consumption of alcohol can have beneficial or harmful effects depending on the amount consumed, age and other characteristics of the person consuming the alcohol, and specifics of the situation. In 2002:

55 percent of U.S. adults were current drinkers.45 percent of U.S. adults do not drink any alcohol at all.

The lowest all-cause mortality occurs at an intake of one to two drinks per day.

The lowest coronary heart disease mortality also occurs at an intake of one to two drinks per day.

Moderation is defined as the consumption of up to one drink per day for women* and up to two drinks per day for men. 12 fluid ounces of regular beer, 5 fluid ounces of wine, or 1.5 fluid ounces of 80-proof distilled spirits count as one drink for purposes of explaining moderation (12 to 14 grams of alcohol each). This definition of moderation is not intended as an average over several days but rather as the amount consumed on any single day.

*Compared with women who do not drink, women who consume one drink per day appear to have a slightly higher risk of breast cancer.

Moderate alcohol consumption may have beneficial health* effects in some individuals. In middle-aged and older adults, a daily intake of one to two alcoholic beverages per day is associated with the lowest all-cause mortality. More specifically, compared to non-drinkers, adults who consume one to two alcoholic beverages a day appear to have a lower risk of coronary heart disease.

*It is not recommended that anyone begin drinking or drink more frequently on the basis of health considerations.

Drinking alcohol every day protects against heart disease in men but not in women, Danish research shows.

A study of 50,000 people found that men who drank daily had a 41% reduced risk of coronary heart disease compared with a 7% drop in men who drank once a week.

But for women, although drinking on at least one day a week was associated with a 36% reduced risk of heart disease compared to those who drank more rarely, the risk was the same whether women had one drink a week or drank moderately each day.

Experts warned the results, published in the British Medical Journal, should not be used to justify heavy drinking.